No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF IL EIN 36-1236610 NONE | Contract Administrator; Claims processing; Other insurance fees and expenses Service code 12 | — | $1.6M |
| GREGORIO MARCO EIN 36-4028033 NONE | Legal Service code 29 | — | $445K |
| NATIONAL INVESTMENT SERVICES, INC. EIN 80-0169636 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $292K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $252K |
| LANER MUCHIN LTD. EIN 36-3088463 NONE | Legal Service code 29 | — | $157K |
| TOTAL ADMINISTRATIVE SERVICES CORP NONE | Claims processing; Contract Administrator Service code 12 | 2302 INTERNATIONAL LN. MADISON, WI 53704 | $156K |
| HINES AND ASSOCIATES, INC. EIN 36-3545085 NONE | Other services Service code 49 | — | $138K |
| BUCK CONSULTANTS LLC EIN 13-3954297 NONE | Actuarial; Consulting (general) Service code 11 | — | $126K |
| ANTHONY ROTTMAN EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $124K |
| DM SIEGEL LTD. EIN 36-3647531 NONE | Accounting (including auditing) Service code 10 | — | $118K |
| BICC SYSTEMS, INC. EIN 36-2852073 NONE | Other services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $98K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing; Contract Administrator Service code 12 | — | $98K |
| TERRY MUSTO EIN 32-2141153 EMPLOYEE | Employee (plan); Plan Administrator Service code 14 | — | $79K |
| DATAMATION IMAGING SERVICES EIN 36-4303011 NONE | Other services Service code 49 | — | $64K |
| IGNAZIA SURDYK EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $63K |
| EMPLOYEE RESOURCE SYSTEMS, INC. EIN 36-3867641 NONE | Other services Service code 49 | — | $59K |
| GRACIELA DELGADO EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| SUZANNE MORRIN EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| JENNIFER KRECJA EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| DR. NADIM KHOURY NONE | Other services Service code 49 | 676 N. SAINT CLAIR CHICAGO, IL 60611 | $54K |
| ELIZABETH STIERLE EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| MARIA DOMINGUEZ EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Contract Administrator Service code 12 | — | $49K |
| NEXGEN NETWORKS, INC. EIN 20-1967195 NONE | Other services Service code 49 | — | $47K |
| NANCY JONES EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $45K |
| PREFERRED NETWORK ACCESS, INC. EIN 36-4018433 NONE | Other services Service code 49 | — | $42K |
| MARIA KARAGIANNAKOS EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| CHRIS KOGUT EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $29K |
| PLANTE MORAN NONE | Accounting (including auditing) Service code 10 | 10 S. RIVERSIDE PLAZA, 900 CHICAGO, IL 60606 | $23K |
| STRATEGIC CAPITAL INV. ADVISORS EIN 36-4268991 NONE | Investment advisory (plan) Service code 27 | — | $20K |
| FAEGRE BAKER DANIELS NONE | Legal Service code 29 | 311 S. WACKER DRIVE, STE 4400 CHICAGO, IL 60606 | $19K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Investment management fees paid indirectly by plan; Float revenue; Custodial (securities) Service code 19 | — | $19K |
| EYEMED VISION CARE LLC EIN 86-0773195 NONE | Contract Administrator; Claims processing Service code 12 | — | $19K |
| JOHNSON & KROL LLC EIN 36-4342024 NONE | Legal Service code 29 | — | $18K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 3,358 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,358 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.